Site Care of Your Central Venous Catheter Sterile

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1 Site Care of Your Central Venous Catheter Sterile Dressing Change Sterile Technique The skin surrounding your catheter s exit site must be kept clean, and a new sterile dressing should be applied on a regular basis. The catheter dressing is usually changed once a week, or sooner if the dressing becomes compromised. Your nurse and doctor will tell you the best frequency for this procedure. Your central venous dressing will be changed using a sterile technique. Before You Begin 1. Wash your hands thoroughly. 2. Prepare your work area. 3. Assemble the following supplies: Prepackaged sterile dressing kit OR Sterile gloves Antiseptic swabsticks 1-inch tape Sterile dressing (gauze or transperant) Special skin protective swabstick (optional) 2007 Coram Inc. COR PE 2.2 Page 1 of 6

2 Basic Steps 1. Wash hands thoroughly. 2. Your dressing should be changed weekly or as directed by your nurse or doctor. Carefully peel off and remove the old tape and dressing from the exit site and discard in your household trash. 2 Do not touch the catheter exit site with your hands when taking off the old dressing. DO NOT USE SCISSORS. NOTE: When a caregiver is removing the old dressing, non-sterile gloves should be worn. 3. Look closely at the skin area around the catheter exit site for signs of infection. Signs of infection include: Redness Irritation Increased soreness Drainage 3 Report any such signs to your nurse immediately. 4. Wash hands again. If a caregiver is helping, they should remove their gloves and wash their hands again. 4 Site Care of Your Central Venous Catheter Sterile Page 2 of 6

3 5. Peel back the paper covering the prepackaged dressing kit. Keep the contents in the plastic portion of the kit. Put on the mask by looping the elastic around the ears. A mask should be worn by the person who is performing the dressing change. 5 If you are having a caregiver assist you, then you do not have to wear a mask as long as you turn your head away from the exit site while the dressing is being changed. If this is not possible, the you, the patient, should also wear a mask Take out the package with the gloves and open it. Carefully pick up one of the sterile gloves from the inside of its cuff and slide your other hand into it. Be careful not to touch the outside of the glove or tray contents with your fingers. 7. Pick up the other glove by sliding the middle and index fingers of your gloved hand under the cuff as shown. 7 Continue to slide your hand into the glove, touching only the sterile OUTSIDE of the glove with your other sterile gloved hand. 8. Open the package of antiseptic swabsticks. Be sure to clean at least 3-4 inches out from the exit site. 8 Site Care of Your Central Venous Catheter Sterile Page 3 of 6

4 9. Clean the catheter site with the antiseptic using the directions that you are specific to the type of antiseptic you are using: Alcohol/Povidone-Iodine Combination Formulation (e.g. ExCel AP ) OR Chlorhexidine Gluconate/Alcohol Combination Formulation (e.g. Chloraprep ) OR Alcohol and Povidone-Iodine Single Formulation (separate packets of alcohol and povidone-iodine) Alcohol/Pvoidone-Iodine Combination Formulation (e.g. ExCel AP ) Disinfect the catheter site using swabsticks (triple pack) Open the package at tear notch to expose the end of the swabsticks. Do not touch the foam tip when removing the swabsticks from the package. Using the first swabstick, clean a 3-4 inch area around the catheter exit site with a repeated back and forth motion using friction for a minimum of 10 seconds. Repeat using the second and third swabsticks. Discard swabsticks after use in the regular household trash. Chlorhexidine Gluconate/Alcohol Combination Formulation (e.g. Chloraprep ) Disinfect the catheter site using the swabsticks (triple pack) Open the package at tear notch to expose the end of the swabsticks. Do not touch the foam tip when removing the swabsticks from the package. Using the first swabstick, clean a 3-4 inch area around the catheter exit site with a repeated back and forth motion using friction for a minimum of 30 seconds. Repeat using the second and third swabsticks. Discard swabsticks after use in the regular household trash. Chlorhexidine Gluconate/Alcohol Combination Formulation (e.g. Chloraprep ) Disinfect the catheter site using the one-step applicator Open the package at tear notch to expose the applicator. Site Care of Your Central Venous Catheter Sterile Page 4 of 5

5 Do not touch the sponge when removing the applicator from the package. Pinch the wings on the applicator to break the ampule and release the antiseptic solution. Wet the sponge by repeatedly pressing and releasing the sponge on the skin until the liquid is released. Using the applicator, clean a 3-4 inch area around the catheter exit site with a repeated back and forth motion using friction for a minimum of 30 seconds. Allow the area to dry completely. Do not blot, fan, or blow on the area to help it dry faster. Let it air dry. Discard swabsticks after use in the regular household trash. Alcohol and Povidone-Iodine Single Formulation Disinfect the catheter site using swabsticks (triple packs of alcohol and povidoneiodine swabsticks) Open the packages at tear notch to expose the ends of the alcohol and povidoneiodine swabsticks. Do not touch the applicator tips when removing the swabsticks from the package. Using the first alcohol swabstick, clean a 3-4 inch area around the catheter exit site using a circular motion, starting at the exit site and working outward. Repeat using the second and third alcohol swabsticks. Using first povidone-iodine swabstick, clean a 3-4 inch area around the catheter exit site using a circular motion, starting at the exit site and working outward. Repeat using the second and third povidone-iodine swabsticks. Discard all swabsticks after use in the regular household trash. 10. Put a new sterile gauze dressing on the exit site. Proceed to step 12 if you are using a clear (transparent) dressing. 10 Site Care of Your Central Venous Catheter Sterile Page 5 of 6

6 11. Secure the edges of the dressing in place with tape Put the new sterile transparent dressing directly on the skin. Remove the paper backing from the sticky side Put the sticky side down over the catheter exit site Press the dressing gently on the skin as you remove the paper backing from the top 12 SPECIAL NOTES: If you are using skin prep, apply this before the transparent dressing. Apply the skin prep to the area around catheter site where the dressing will be placed. Do not use gauze if you are using a transparent dressing Loop extra catheter tubing up and tape to your chest. AVOID TAPING CATHETER DIRECTLY TO DRESSING. 13 Site Care of Your Central Venous Catheter Sterile Page 6 of 6

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